Second opinions and designated health practitioners

Second opinions can be requested for several reasons:

• when the information on a Work Capacity Medical Certificate is inadequate, unclear, or does not appear to align with other information on the person's file
• when the person's supporting documents aren’t enough to assess their Supported Living Payment application
• when the practitioner completing the certificate is unable to determine a person’s work capacity, including if they feel coerced or pressured by the patient
• when the client requests one.

If you or your patient would like a second opinion, you can indicate this on the medical certificate. You can also contact the local regional health and disability team who will be able to organise this.

Before a  Designated Health Practitioner (DHP) meets with a patient, they’ll request a report from their usual practitioner.

The report should outline the patient’s:

• medical history
• current and previous treatment, and
• any other important information relevant to their Work and Income benefit or support. 

We’ll pay the patient’s usual practitioner for providing this report.

The DHP is expected to

• meet with and assess the patient within 10 days of referral, and
• provide a report to us within five days of the assessment.

We’ll send a copy of the report to the patient’s usual practitioner.

As a Designated Health Practitioner (DHP) you’ll provide independent medical assessments to help us determine a person’s ability to work and their eligibility for benefits.

As a DHP, you’ll:

• assess a person’s capacity for work
• complete a specialist report for us
• help inform decisions about benefit entitlement and employment support.

You’ll be paid for each assessment, which includes meeting with the client and submitting a report within a set timeframe.

Training and support

Before you start, you’ll need to complete a 2-hour online training session. You’ll be reimbursed for your time.

The training covers:

• our main benefits and supports
• the role and expectations of a DHP.

After training, you’ll receive a comprehensive guide to support you when completing assessments and reports.

To become a Designated Health Practitioner, you need to:

• be a registered medical or nurse practitioner
• be vocationally registered in New Zealand
• have at least 5 years work experience in the New Zealand health system
• have a demonstrated interest in rehabilitation or disability medicine
• provide a peer referee who can endorse your suitability for the role.  

Before applying, contact your local Health and Disability team. They’ll give you more information and answer any questions. Their details are available on your regional Work and Income Health Pathway.

Once your application is accepted, the Principal Health Advisor will contact you to arrange training.

Once completed the form should be returned to the Health and Disability Team.

Before payment is made, we’ll confirm that a report was requested by the client’s case manager.

From 2 April 2025, the hourly rate for DHP assessments is:

• $180.00 (plus GST) per hour, for up to 2 hours per assessment
• in exceptional cases, an additional hour may be claimed.

You may also be paid for:

• missed or rescheduled appointments
• reports provided by host practitioners (the client’s usual medical or nursing practitioner).

Invoicing

Send your invoice to MSD_INVOICES@MSD.GOVT.NZ use either PDF or Microsoft Word formats as our system can only read these formats.

Alternatively you can send your Invoice in any format to us using NAC_Accounts_Payable@msd.govt.nz

Payment amounts

Activity:	Amount:
Designated health practitioner assessment	$180.00 (plus GST) per hour up to 2 hours – with option to pay an additional hour in exceptional cases
Fee for missed appointment (if client reschedules)	$90.00 (plus GST)
Fee for missed appointment (if client does not attend at any stage)	$270.00 (plus GST)
Payment to host practitioner (usual medical or nursing practitioner) for a report	$90.00 (plus GST)

If you have any questions or if there's something you'd like to discuss, your Regional Health and Disability Team's details are available on your regional Work and Income Health Pathway.